title: The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy.
abstract: OBJECTIVE
  Transrectal ultrasound (TRUS) guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS.
  
  
  METHODS
  473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS) was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test.
  
  
  RESULTS
  Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001). In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level.
  
  
  CONCLUSIONS
  The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.
authors.affiliation: Okmeydani Training and Research Hospital, Department of Urology, Istanbul, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Otunctemur
authors.forename: Murat
authors.initials: M
authors.lastname: Dursun
authors.forename: Huseyin
authors.initials: H
authors.lastname: Besiroglu
authors.forename: Emre
authors.initials: E
authors.lastname: Can Polat
authors.forename: Suleyman Sami
authors.initials: SS
authors.lastname: Cakir
authors.forename: Emin
authors.initials: E
authors.lastname: Ozbek
authors.forename: Tahir
authors.initials: T
authors.lastname: Karadeniz
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000285:Administration, Rectal; D000368:Aged; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D001707:Biopsy, Needle / Q000009:adverse effects*; D005782:Gels; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D005782:Gels; D008012:Lidocaine